Big Horse


Histories of public health

Comparisons of responses to the Covid-19 crisis across national lines yield as many questions as answers. Divergent histories of public health programs, differences in cultural norms, population density, age distributions, and internal migration patterns create a muddy picture for causal understandings of the national variations in impact.

PETER BALDWIN’s Contagion and the State in Europe 1830-1930 provides a fundamental historical study on these questions. The book explores the “reasons for the divergence in public health policies in Britain, France, Germany and Sweden” and the “spectrum of responses to the threat of contagious diseases such as cholera, smallpox and syphilis.”

From the book’s conclusion:

“Since at least the era of absolutism, preventing and dealing with contagious and epidemic disease have together been one of the major tasks of states. Given that, from the first European cholera epidemics to the cusp of the antibiotical era, the problem faced by each country has been much the same in biological terms, why have they responded in markedly different ways? Especially before the bacteriological revolution, etiological knowledge was inextricably bound up with political, administrative, economic, and geographic factors.

The fundamental implication of a political interpretation of public health is that prophylactic strategy and ideology are correlated. Approaches to prevention may be expected to reflect common assumptions held in a society as to where group and individual interests diverge, how much autonomy citizens can rightfully claim, the power of the community over its members. The right to be spared prophylactic imposition was not the only measure of liberty; there was also the freedom from disease. Traditional conservative quarantinists argued this line. Conversely, liberals objected to such interventions when they impinged on personal liberties too drastically or for insufficiently redeeming purpose. There was, also an understanding of public health that transcended such sterile oppositions between community and individual, holding that society’s concern with public health was a positive freedom that, while limiting absolute individual autonomy, returned to each a higher measure of liberation from affliction.

Such political interpretations of preventive strategies appear, however, to have inverted matters. It was not British liberalism or German interventionism (to take again the outliers) that, by themselves, determined prophylactic strategies, but the imperatives of geoepidemiology, and the associated factors identified here, that helped shape not only the preventive precautions they encouraged, but indeed the very political traditions of these nations.”

Link to the book.

  • A new podcast from the Cambridge history department discusses Baldwin’s book as a guide for thinking through the present crisis. Link.
  • For the classic international history of public health, see George Rosen’s 1958 A History of Public Health. Link. And see his 1947 paper “What Is Social Medicine?” Link.
  • “After yellow fever was firmly ensconsed, it underpinned a military and political status quo, keeping South America under Spanish rule. After 1780, and particularly in the Hatian Revolution, yellow fever undermined the status quo by assisting independence movements in the America tropics.” A 1999 article by J.R. McNeill on “Ecology, Epidemics, and Empires.” Link.


The health impacts of increasing wages for care workers

PhD candidate in Public Policy at UC Berkeley KRISTA RUFFINI studies the health, education, and labor market outcomes of government policies. Her job market paper looks at the consequences of a 10% minimum wage increase for nursing home workers on on patient health.

From the abstract:

“I find that a ten percent increase in the minimum wage raises low-skilled nursing home workers’ earnings one to two percent, reduces separations, and increases stable hires. These earnings gains and increases in firm-specific human capital translate into marked improvements in patient health and safety. A ten percent increase in the minimum wage would prevent at least 15,000 deaths, lower the number of inspection violations by one to two percent, and reduce the cost of preventable care. Considering costs elsewhere in the health system, savings from pressure ulcer treatment alone offsets up to half of the increased wage bill, and if the social value of increased longevity for nursing home residents is at least $21,000, well below existing estimates, higher wages in this sector are fully offset by improvements in care.”

Link to the paper, and to Ruffini’s website.

Each week we highlight great work from a graduate student, postdoc, or early-career professor. Have you read any excellent research recently that you’d like to see shared here? Send it our way:

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  • “The US was unprepared for a labor market crisis of this magnitude.” On the blog, historian Aaron Benanav enumerates the underlying problems laid bare by this crisis. Link.
  • To have open alongside Benanav’s post: the latest BLS report on the employment situation was released yesterday morning, revealing the tip of the unemployment spike. Link. And, relatedly, a new EPI analysis concludes that “3.5 million workers likely lost their employer-provided health insurance in the past two weeks.” Link.
  • A dizzying report on the export blocking, clandestine operations, and missing shipments proliferating in global markets for PPE and testing kits, as states adopt increasingly questionable measures to edge out competition in access to lifesaving goods. Kim Willsher et al in the Guardian. Link.
  • “If the frugal four continue to obstruct a common fiscal response to this crisis, the remaining eurozone countries will be right to ask if they are not better off going their own way.” On the topic of last week’s newsletter, David Adler and Jerome Roos analyze the consequences of the Dutch-led opposition to corona bonds. Link.
  • “This document proposes a system for secure and privacy-preserving proximity tracing at large scale.” A framework for secure contact tracing, by Carmela Toncoso et al. Link.
  • Mariana Mazzucato on the growing need for public investment: “Government should be supporting businesses to continue paying wages even when workers are not working–simultaneously helping households retain their incomes, preventing the virus from spreading, and making it easier for businesses to resume production once the crisis is over. When it comes to households, governments should look to the possibility of debt relief.” Link.
  • “In the 2000s, newly-analyzed tax data revealed that top incomes had begun a dramatic upward climb in the early 1980s. I explain why it took two decades for this increase to become salient.” Daniel Hirschman on the relationship of theory to observation in social scientific analysis. Link.
  • Bill Freund with a labor history of East Africa, from 1500- post independence. Link.
  • “Drawing on archival records from the ‘Standing Committee on the Euro-currency Market,’ we trace the expansion of the Eurodollar market during the 1970s to present a theory of financial globalization that emphasizes ‘positive integration.'” Benjamin Braun, Arie Krampf and Steffen Murau offer an alternative history of globalization. Link.
  • At Autonomy, Lukas Kikuchi and Ishan Khurana map the risk of contracting a virus at more than 250 different occupations. Link.
  • “This paper describes broad regional and temporal trends in the evolution of international trade and international factor flows between 1700 and 1870, including key differences in trade costs across space and time.” A new paper by Carol H. Shiue, Wolfgang Keller, and Markus Lampe on the relationship between trade and global economic divergence. Link.
  • 3P on improving the current crisis response: administer payrolls through the government, institute a small basic income, and add a universal child benefit. Link. At VoxEU, Camille Landais, Emmanuel Saez, and Gabriel Zucman propose a Europe-wide progressive wealth tax. Link.
  • “Both economic historians and historians of capitalism see economic structure and organization as historically specific. Both challenge the economist’s conception of an ideal, rarified market. Both seek to denaturalize the economic order. Yet the two sides are engaged in a dialogue of the deaf, where no communication, much less synthesis, takes place.” A 2019 article by Barry Eichengreen bridges disciplinary gaps in the study of economic history. Link.
  • “This dissertation argues for the importance of intelligence-gathering, including espionage, for understanding the relationship between the Russian Empire, the Qing Dynasty, and European actors, from the mid-seventeenth to the early nineteenth century. It relies on archival sources from Moscow, St. Petersburg, Paris, London, and Rome, as well as published materials. I begin by investigating how seventeenth-century Siberians compiled information about China, and how maps and documents were transmitted first to Moscow and then to Western Europe to be republished for wider audiences. I then examine the post-Petrine shift to more specialized forms of intelligence-gathering, focusing on industrial espionage in the Moscow-Beijing trade caravan. On the mid-eighteenth-century Russo-Qing border, the dissertation follows the building of a robust Russian intelligence network in Qing Mongolia amid unprecedented inter-imperial tension, and its ultimate failure to achieve desired geopolitical ends. These intelligence failures are shown to provide a compelling new explanation for the collapse of European imperial attempts at diplomacy in East Asia in the last third of the eighteenth century.” Gregory Afinogenov’s 2016 PhD dissertation. Link. (See also: Afinogenov’s forthcoming book, Spies and Scholars.)

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